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| IMAGE IN EUS |
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| Year : 2015 | Volume
: 4
| Issue : 4 | Page : 351-352 |
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Gastric gastrointestinal stromal tumor mimicking cystic tumor of the pancreas: Diagnosed by endoscopic ultrasound-fine-needle aspiration
Surinder S Rana1, Vishal Sharma1, Ravi Sharma1, Deepak Gunjan1, Lovneet Dhalaria1, Rajesh Gupta2, Deepak K Bhasin1
1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
2 Department of Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| Date of Submission | 04-May-2015 |
| Date of Acceptance | 18-May-2015 |
| Date of Web Publication | 25-Nov-2015 |
Correspondence Address:
Surinder S Rana
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh - 160 012
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2303-9027.170452
How to cite this article:
Rana SS, Sharma V, Sharma R, Gunjan D, Dhalaria L, Gupta R, Bhasin DK. Gastric gastrointestinal stromal tumor mimicking cystic tumor of the pancreas: Diagnosed by endoscopic ultrasound-fine-needle aspiration. Endosc Ultrasound 2015;4:351-2 |
How to cite this URL:
Rana SS, Sharma V, Sharma R, Gunjan D, Dhalaria L, Gupta R, Bhasin DK. Gastric gastrointestinal stromal tumor mimicking cystic tumor of the pancreas: Diagnosed by endoscopic ultrasound-fine-needle aspiration. Endosc Ultrasound [serial online] 2015 [cited 2022 Jun 26];4:351-2. Available from: http://www.eusjournal.com/text.asp?2015/4/4/351/170452 |
A 53-year-old male presented with upper abdominal pain of 3 months duration. On clinical examination, a vague lump was palpable in the epigastric region. Contrast-enhanced computed tomography (CECT) of the abdomen revealed a large cystic lesion measuring 8 cm near the tail of the pancreas [Figure 1]. It had an enhancing solid component in the periphery of the cyst [Figure 2]. Upper gastrointestinal endoscopy revealed normal gastric mucosa. A possibility of cystic pancreatic neoplasm was kept and the patient underwent endoscopic ultrasound (EUS). The EUS revealed a heteroechoic lesion arising from the stomach wall with solid and cystic areas [Figure 3]. There were small anechoic areas in the solid component of the lesion suggestive of necrosis [Figure 4]. The lesion could be seen arising from the muscularis propria. EUS-guided fine-needle aspiration (FNA) was performed from the solid component and the cytology revealed features suggestive of a spindle cell tumor [Figure 5]. The patient underwent surgical excision of the tumor and the histopathological examination confirmed the presence of gastrointestinal stromal tumor (GIST).  | Figure 1: CT of the abdomen: Large cystic lesion measuring 8 cm in the tail of the pancreas
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 | Figure 2: CT of the abdomen: Enhancing solid component in the periphery of the cyst
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 | Figure 3: EUS: Heteroechoic lesion arising from the stomach wall with solid and cystic areas
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 | Figure 4: EUS: Small anechoic areas in the solid component of the lesion
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GISTs are mesenchymal tumors, which usually arise from the stomach, small intestine, large intestine, or esophagus. They usually present as solid masses and cystic degeneration of a GIST is very rare. [1],[2] The cystic degeneration is usually seen in larger tumors because of liquefaction and hemorrhage. EUS-FNA may provide an opportunity to obtain the tissue for preoperative diagnosis. [3],[4] EUS findings are variable and may include complex cystic lesions with hyperechoic debris or hypoechoic rounded lesion. [2],[3],[4],[5]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest and no financial disclosures to be made.
| References | |  |
| 1. | Kumar A, Jakhmola CK, Chauhan SS, et al. Atypical presentation of gastrointestinal stromal tumor masquerading as a large duodenal cyst: A case report. Int J Surg Case Rep 2015;9:123-6.  |
| 2. | Ambrosio MR, Rocca BJ, Mastrogiulio MG, et al. Cystic gastrointestinal stromal tumors of the pancreas simulating cystoadenocarcinoma. Report of three cases and short review of the literature. Histol Histopathol 2014;29:1583-91. |
| 3. | Sepe PS, Moparty B, Pitman MB, et al. EUS-guided FNA for the diagnosis of GI stromal cell tumors: Sensitivity and cytologic yield. Gastrointest Endosc 2009;70:254-61. |
| 4. | Harindhanavudhi T, Tanawuttiwat T, Pyle J, et al. Extra-gastrointestinal stromal tumor presenting as hemorrhagic pancreatic cyst diagnosed by EUS-FNA. JOP 2009;10:189-91. |
| 5. | Naitoh I, Okayama Y, Hirai M, et al Exophytic pedunculated gastrointestinal stromal tumor with remarkable cystic change. J Gastroenterol 2003;38:1181-4. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
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